title: The sap from Euphorbia peplus is effective against human nonmelanoma skin cancers.
abstract: BACKGROUND
  The sap from Euphorbia peplus, commonly known as petty spurge in the U.K. or radium weed in Australia, has been used as a traditional treatment for a number of cancers.
  
  
  OBJECTIVE
  To determine the effectiveness of E. peplus sap in a phase I/II clinical study for the topical treatment of basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and intraepidermal carcinomas (IEC).
  
  
  METHODS
  Thirty-six patients, who had refused, failed or were unsuitable for conventional treatment, were enrolled in a phase I/II clinical study. A total of 48 skin cancer lesions were treated topically with 100-300 μL of E. peplus sap once daily for 3 days.
  
  
  RESULTS
  The complete clinical response rates at 1 month were 82% (n = 28) for BCC, 94% (n = 16) for IEC and 75% (n = 4) for SCC. After a mean follow-up of 15 months these rates were 57%, 75% and 50%, respectively. For superficial lesions < 16 mm, the response rates after follow-up were 100% for IEC (n = 10) and 78% for BCC (n = 9).
  
  
  CONCLUSIONS
  The clinical responses for these relatively unfavourable lesions (43% had failed previous treatments, 35% were situated in the head and neck region and 30% were > 2 cm in diameter), are comparable with existing nonsurgical treatments. An active ingredient of E. peplus sap has been identified as ingenol mebutate (PEP005). This clinical study affirms community experience with E. peplus sap, and supports further clinical development of PEP005 for the treatment of BCC, SCC and IEC.
authors.affiliation: Mater Radiation Oncology Centre, Brisbane, Qld, Australia.
authors.forename: J R
authors.initials: JR
authors.lastname: Ramsay
authors.forename: A
authors.initials: A
authors.lastname: Suhrbier
authors.forename: J H
authors.initials: JH
authors.lastname: Aylward
authors.forename: S
authors.initials: S
authors.lastname: Ogbourne
authors.forename: S-J
authors.initials: SJ
authors.lastname: Cozzi
authors.forename: M G
authors.initials: MG
authors.lastname: Poulsen
authors.forename: K C
authors.initials: KC
authors.lastname: Baumann
authors.forename: P
authors.initials: P
authors.lastname: Welburn
authors.forename: G L
authors.initials: GL
authors.lastname: Redlich
authors.forename: P G
authors.initials: PG
authors.lastname: Parsons
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D019665:Euphorbiaceae; D006801:Humans; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D010936:Plant Extracts